| 陈祥科,邢莉菊,孙恒聪,等.经颅直流电刺激结合局部振动对脑卒中后偏瘫 53例肢体运动功能康复的影响[J].安徽医药,2024,28(1):45-48. |
| 经颅直流电刺激结合局部振动对脑卒中后偏瘫 53例肢体运动功能康复的影响 |
| Influence of transcranial direct current stimulation combined with local vibration on the rehabilitation of limb motor function in 53 patients with hemiplegia after stroke |
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| DOI：10.3969/j.issn.1009-6469.2024.01.010 |
| 中文关键词: 经颅直流电刺激 振动 脑卒中 偏瘫 肢体运动功能 |
| 英文关键词: Transcranial direct current stimulation Ibration Stroke Hemiplegia Limb motor function |
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| 中文摘要: |
| 目的探讨经颅直流电刺激( tDCS)结合局部振动对脑卒中后偏瘫( HAS)病人 53例肢体运动功能康复的影响。方法选择 2019年 2月至 2021年 9月三亚市人民医院收治的 106例 HAS病人，将其按随机数字表法划分为 tDCS组( n=53，tDCS治疗)和联合组( n=53，tDCS+局部振动治疗)。于治疗前、治疗 8周后采用中国卒中量表( CSS)对两组神经功能进行评定，采用 FuglMeyer评估表( FMA)、 Wolf运动功能测试量表( WMFT)对两组肢体运动功能进行评定，采用改良 Barthel指数量表( MBI)对两组日常生活能力进行评定，同时检测两组血清神经生长因子( NGF)、神经营养素 -3(NT-3)、S100-β蛋白( S100-β)水平。结果治疗后，两组 CSS评分、血清 S-100β水平均较治疗前明显降低( P<0.05)且联合组 CSS评分［(7.21±1.76)分比( 9.47±2.13)分］、血清 S-100β水平［( 0.67±0.22)μg/L比( 0.93±0.28)μg/L］均明显较 tDCS组低，(P<0.05)；两组 FMA、WMFT、MBI评分及血清 NGF、 NT-3水平均较治疗前明显升高( P<0.05)且联合组 FMA评分［(71.28±10.59)分比( 63.87±9.24)分］、 WMFT评分［(59.36±5.73)分比( 52.11±4.27)分］、 MBI评分［( 73.28±6.5，7)分比( 64.58±7.62)分］及血清 NGF［( 147.96±17.51)ng/L比( 139.81±15.37)ng/L］、 NT-3［(11.25±1.94)ng/L比( 9.62±1.53)ng/L］水平均明显较 tDCS组高( P<0.05)。结论对 HAS病人实施 tDCS结合局部振动治疗，可有效调节血清 NGF、NT-3、S100-β水平，明显改善神经功能及肢体运动能力，显著增强日常生活能力。 |
| 英文摘要: |
| Objective To investigate the influence of transcranial direct current stimulation (tDCS) combined with local vibration onthe rehabilitation of limb motor function in 53 patients with hemiplegia after stroke (HAS).Methods A total of 106 HAS patients accept-ed by Sanya People's Hospital from February 2019 to September 2021 were selected and assigned to the tDCS group (n=53, tDCS treat- ment) and combined group (n=53, tDCS+local vibration) using random number table method. Before treatment and after 8 weeks of treat-ment, the Chinese Stroke Scale (CSS) was carried out to evaluate the neurological function of the two groups, and the Fugl-Meyer Assess-ment (FMA) and Wolf Motor Function Test (WMFT) were carried out to evaluate the motor function of the two groups, the modified Barthelindex (MBI) was carried out to evaluate the activities of daily living in the two groups, and the serum levels of nerve growth factor (NGF),neurotrophin-3 (NT-3), and S100-β protein (S100-β) in the two groups were measured.Results The CSS scores and serum S-100β levels in the two groups were obviously lower after treatment (P<0.05), and the CSS score of the combined group [(7.21±1.76) points vs. (9.47± 2.13) points] and the serum S-100β level [(0.67±0.22) μg/L vs. (0.93±0.28) μg/L] were significantly lower than those in the tDCS group (P <0.05); the FMA, WMFT, MBI scores, and serum NGF and NT-3 levels in the two groups were obviously higher after treatment (P<0.05), and the FMA score [(71.28±10.59) points vs. (63.87±9.24) points], WMFT score [(59.36±5.73) points vs. (52.11±4.27) points] and MBI score [(73.28±6.57) points vs. (64.58±7.62) points] and the levels of serum NGF[(147.96±17.51) ng/L vs. (139.81±15.37) ng/L] and NT-3 [(11.25±1.94) ng/L vs. (9.62±1.53) ng/L] in the combined group were significantly higher than those in tDCS group (P<0.05). Conclu- sion tDCS combined with local vibration therapy for HAS patients can effectively regulate the levels of serum NGF, NT-3 and S100-β, obviously ameliorate the neurological function and limb movement ability, and obviously enhance daily life. |
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